Differential Effects of Later Cord Clamping on Bilirubin Levels in Normal and Diabetic Pregnancies

Abstract Purpose: To investigate the effect of later cord clamping on bilirubin levels and phototherapy rates in normal pregnancy term neonates and diabetic pregnancy neonates.Methods: This is a prospective study that enrolled pregnant women without pregnancy complications and those with diabetes according to the criteria. The subjects were randomized in a 1:1 ratio to either immediate cord clamping or later cord clamping. The final data analysis involved 132 cases of diabetic pregnancy and 129 cases of normal pregnancy. The main outcomes were neonatal the transcutaneous bilirubin values in 2-4 days postpartum and the phototherapy rate.Results: In diabetic pregnancy, neonatal bilirubin levels on the 2-4 day postpartum and phototherapy rates were significantly higher in later cord clamping group than in immediate cord clamping group, while in normal pregnancy, there was no statistical difference in bilirubin values and phototherapy rates between different clamping methods. After receiving later cord clamping, bilirubin levels on the third postnatal day and the rate of neonates needing phototherapy were higher in the diabetic pregnancy group than in the normal pregnancy group.Conclusions: Later cord clamping increases the risk of jaundice in newborns whose mothers have diabetes, but has no effect on newborns with normal pregnancy.Trial registration: ClinicalTrials.gov: NCT04369313; date of registration: April 27, 2020 (retrospectively registered)